Article Highlights
- Team-based care linked to higher preventive service use in children and mothers
- Preventive gains include more well-child visits, continuity of care, and screenings
- Largest gains were seen among Black and Hispanic children facing care disparities
- HealthySteps may reduce racial and ethnic disparities in pediatric primary care
Publication
American Journal of Preventive Medicine, June 2026
Authors
Renata E. Howland PhD, MPH, Kelly Terlizzi MS, Elizabeth Frenette MPH, Shannon Franz MS, Jessica Bushar MPH, Rahill Briggs PsyD, Jennifer Tracey MHA, Charles Neighbors PhD, MBA
Abstract
This study examines the association of HealthySteps – a two-generation, team-based pediatric primary care model – on preventive care and healthcare utilization for Medicaid-insured children and mothers, and differences across racial/ethnic groups.
Methods
This retrospective cohort study used linked HealthySteps and Medicaid claims data to compare 12-month outcomes for children receiving comprehensive services with a matched group of similar Medicaid-insured children and mothers. Data used in this study were collected from 2016 to 2021 and analyzed from 2022 to 2026.
Results
HealthySteps was associated with higher rates of any well-child visit (89.0% vs. 79.6%), attendance of 6+ well-child visits by 15 months of age (64.2% vs. 54.0%), continuity of care with the same provider (65.3% vs. 52.8%), developmental screening (37.9% vs. 26.9%), and Early Intervention (13.8% vs. 8.9%). HealthySteps was also associated with greater likelihood of an emergency department visit (43.9% vs. 38.7%), though not high ED usage (2+ visits). Compared with their counterparts, preventive care increases associated with HealthySteps were larger for Black, Hispanic, and, to a lesser extent, Asian children than for White non-Hispanic children. Among mothers, HealthySteps was associated with greater family planning services (35.8% vs. 31.6%), maternal depression screening (10.9% vs. 8.8%), postpartum care (29.5% vs. 24.6%), and ED visits (36.1% vs. 33.5%), as well as fewer lactation services (6.9% vs. 9.4%).
Conclusions
Improvements in preventive care associated with HealthySteps represent meaningful clinical impact, as timely care in the first three years is crucial for healthy development. The larger gains among Black, Hispanic, and Asian children also highlight HealthySteps potential to mitigate persistent disparities in preventive care receipt.